Endocrine Abstracts

Introduction: Children with type 1 diabetes mellitus are at increased risk of autoimmune thyroid and coeliac disease. Reported prevalence figures for thyroid and coeliac disease in this population has been reported in European studies as 3–8%¹ and 1–10%² respectively. Current NICE guidelines (June 2009) recommend screening for both conditions at diagnosis, and then screening annually for thyroid disease thereafter. We aimed to: i) estimate prevalence of these conditions in a British cohort; ii) determine whether NICE guidelines are being adhered to.

Methods: We ran a search on a web-based platform for paediatric patients with diabetes (Twinkle .Net) in a Greater London district general hospital trust for details of patients’ thyroid function and anti-transglutaminase antibody tests during the past year. Electronic clinical notes and correspondence were individually checked for diagnoses of autoimmune disease.

Results: Prevalence of coeliac disease was 4.29%, and 2.45% for thyroid disease (n=163). 76.07% of all patients had thyroid function tests in the last year and 70.83% of newly diagnosed patients had an autoimmune screen at diagnosis, in accordance with NICE guidelines.

Conclusion: Despite international variation in diabetes epidemiology, our prevalence figures are consistent with the limited literature. Screening for asymptomatic disease was sub-optimal, with poor patient compliance in adolescents playing a role. Untreated thyroid and coeliac disease can adversely affect glycaemic control, and therefore clinicians’ awareness of their prevalence and regular screening is paramount.

References

1. Hansen D, Bennedbaek FN, Hoier-Madsen M, et al. A prospective study of thyroid function, morphology and autoimmunity in young patients with type 1 diabetes. Eur J Endocrinol 2003 148 245–251.

2. Prevalence of celiac disease and follow-up of EMA in children and adolescents with type 1 diabetes mellitus. J Pediatr Gastr Nutr 2003 37 67–71.